Senior Appeals Examiner, CVS Health

CVS Health

Location:
United States

Category:
Customer Service

Contract Type:
Employment contract

Salary:

18.50 - 42.35 USD / Hour

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Job Description:

Responsible for managing to resolution complaint/appeal scenarios for all products, which may contain multiple issues and, may require coordination of responses from multiple business units. Ensure timely, customer focused response to complaints/appeals. Identify trends and emerging issues and report and recommend solutions.

Job Responsibility:

Managing to resolution complaint/appeal scenarios for all products
Coordinating responses from multiple business units
Ensuring timely, customer focused response to complaints/appeals
Identifying trends and emerging issues and reporting and recommending solutions

Requirements:

1 plus years knowledge of plan documents, claims research, letter writing
1 plus years working with appeals, claims, or compliance
1 plus years experience working with documenting and interpreting Health Insurance plans
Understand excel and word
Able to interpret benefits
Healthcare experience
Associate Degree or High School Diploma/GED and equivalent experience

Nice to have:

3 plus years of prior claim or health insurance experience
Familiarity with medical terminology, self funding or ERISA requirements

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
Wellness screenings
Tobacco cessation and weight management programs
Confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
October 15, 2025

Expiration:
October 31, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Senior Appeals Examiner